Population decline has been a problem in Russia for decades. Government has put in place a range of initiatives to reverse the downward demographic trend. Among them is a key programme to lower infant mortality rates.

The birth rate has been traditionally high in Dagestan, with Health Ministry figures showing 50,000 babies born there every year.

A third of Dagestan’s population of 2.5 million – some 800,000 – are children.
 
But a large number of babies fail to get through infancy.

Doctors say the number of babies born with health problems is on the increase in the republic.

Head of the region’s children’s hospital, Bashir Makhachev, says: “the number of such patients is growing each year, so we will have to extend the intensive care unit in the future. Then we'll have the opportunity to treat more babies.”

More than half of the population live in villages and work in agriculture, and that’s where the majority of unhealthy babies come from.

Doctors say the infant mortality rate there is high for many reasons, the main one being low living standards, the poor health of women and inbreeding.

Dagestan’s Health Minister Ilyas Mamaev says “thyroid and anemia-related diseases are endemic to this territory. These diseases would certainly impact the health of a baby which born here.”

Russia has embarked on a massive investment programme under the national project scheme. The Health Ministry says new medical equipment has been installed in all the local hospitals.  They've even been provided with special child care ambulances.

But even with all that technical help health officials admit there is still a long way to go before the situation changes.